Provider Demographics
NPI:1629082177
Name:CHELMSFORD FAMILY PRACTICE, PC
Entity Type:Organization
Organization Name:CHELMSFORD FAMILY PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-251-3159
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-0248
Mailing Address - Country:US
Mailing Address - Phone:978-251-3159
Mailing Address - Fax:978-251-0636
Practice Address - Street 1:10 ADAMS ST
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1746
Practice Address - Country:US
Practice Address - Phone:978-251-3159
Practice Address - Fax:978-251-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9786619Medicaid
MAM20739Medicare PIN